Endoscopic surgical clip applier

ABSTRACT

An apparatus for application of surgical clips is provided and includes a lockout system selectively engageble with a pusher bar to prevent the pusher bar from returning to a home position and to prevent a trigger from completing a full stroke when a plurality of clips are substantially exhausted. The apparatus may include a trip mechanism including a trip lever biased into contact with the pusher bar, wherein distal movement of the drive bar moves the trip mechanism until the trip lever engages a lip of the pusher bar and in turn distally moves the pusher bar. The apparatus may include a wedge plate including a distal end placeable between spaced-apart jaw members, wherein the wedge plate is moved proximally to withdraw the distal end thereof from between the jaw members when a drive channel is moved in a distal direction.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.13/760,635 filed Feb. 6, 2013, now U.S. Pat. No. 8,814,884, which is adivisional of U.S. patent application Ser. No. 12/055,446 filed Mar. 26,2008, now U.S. Pat. No. 8,382,773, which claims benefit of U.S.Provisional Application No. 60/920,114 filed Mar. 26, 2007, and thedisclosures of each of the above-identified applications are herebyincorporated by reference in their entirety.

BACKGROUND

1. Technical Field

The technical field relates to surgical clip appliers. Moreparticularly, the present disclosure relates to an endoscopic surgicalclip applier having a mechanism for stabilizing the jaw structure duringthe insertion of a surgical clip.

2. Description of Related Art

Endoscopic staplers and clip appliers are known in the art and are usedfor a number of distinct and useful surgical procedures. In the case ofa laparoscopic surgical procedure, access to the interior of an abdomenis achieved through narrow tubes or cannulas inserted through a smallentrance incision in the skin. Minimally invasive procedures performedelsewhere in the body are often generally referred to as endoscopicprocedures. Typically, a tube or cannula device is extended into thepatient's body through the entrance incision to provide an access port.The port allows the surgeon to insert a number of different surgicalinstruments therethrough using a trocar and for performing surgicalprocedures far removed from the incision.

During a majority of these procedures, the surgeon must often terminatethe flow of blood or another fluid through one or more vessels. Thesurgeon will often apply a surgical clip to a blood vessel or anotherduct to prevent the flow of body fluids therethrough during theprocedure. An endoscopic clip applier is known in the art for applying asingle clip during an entry to the body cavity. Such clips are typicallyfabricated from a biocompatible material and are usually compressed overa vessel. Once applied to the vessel, the compressed clip terminates theflow of fluid therethrough.

Endoscopic clip appliers that are able to apply multiple clips inendoscopic or laparoscopic procedures during a single entry into thebody cavity are described in commonly-assigned U.S. Pat. Nos. 5,084,057and 5,100,420 to Green et al., which are both incorporated by referencein their entirety. Another multiple endoscopic clip applier is disclosedin commonly-assigned U.S. Pat. No. 5,607,436 by Pratt et al., thecontents of which is also hereby incorporated by reference herein in itsentirety. These devices are typically, though not necessarily, usedduring a single surgical procedure. U.S. patent application Ser. No.08/515,341 now U.S. Pat. No. 5,695,502 to Pier et al., the disclosure ofwhich is hereby incorporated by reference herein, discloses aresterilizable surgical clip applier. The clip applier advances andforms multiple clips during a single insertion into the body cavity.This resterilizable clip applier is configured to receive and cooperatewith an interchangeable clip magazine so as to advance and form multipleclips during a single entry into a body cavity. One significant designgoal is that the surgical clip be loaded between the jaws without anycompression of the clip from the loading procedure. Such bending ortorque of the clip during loading often has a number of unintendedconsequences. Such compression during loading may alter slightly thealignment of the clip between the jaws. This will cause the surgeon toremove the clip from between the jaws for discarding the clip.Additionally, such preloading compression may slightly compress parts ofthe clip and change a geometry of the clip. This may require the surgeonto remove the compressed clip from between the jaws for discarding theclip.

Endoscopic or laparoscopic procedures are often performed remotely fromthe incision. Consequently, application of clips may be complicated by areduced field of view or reduced tactile feedback for the user at theproximal end of the device. It is therefore desirable to improve theoperation of the instrument by providing an indication to the user of afiring of an individual clip, the depletion of the clips contained inthe loading unit, or any other surgical event. It is also desirable toprovide a surgical clip applier that promotes a successful loading ofthe clip and that wedges the jaws of the surgical clip applier open,then loads the clip between the jaws, in order to prevent any damage orexcessive compression of the clip and prevents compression of the jawson the clip before firing.

SUMMARY

The present disclosure relates to an endoscopic surgical clip applier.

According to an aspect of the present disclosure, an apparatus forapplication of surgical clips to body tissue is provided and includes ahandle assembly; a shaft assembly extending distally from the handleassembly and defining a longitudinal axis; a plurality of surgical clipsdisposed within the shaft assembly; jaws mounted adjacent a distal endportion of the shaft assembly, the jaws including a pair of jaw membersmovable between a spaced-apart and an approximated position; a clippusher bar configured to individually distally advance a surgical clipto the jaws while the jaw members are in the spaced apart position; adrive bar at least partially disposed within the handle assembly and theshaft assembly, the drive bar being longitudinally movable in responseto actuation of a trigger of the handle assembly; and a drive channelpositioned adjacent the first and second jaw members to move the jawmembers to the approximated position.

The apparatus further includes a lockout system configured toselectively engage the clip pusher bar to prevent the clip pusher barfrom returning to a home position and to prevent the trigger fromcompleting a full stroke when the plurality of clips are substantiallyexhausted.

The lockout system may include a pusher-bar latch mechanism supported inthe shaft assembly. In use, a lock-out bar of the latch mechanism may beactuated to engage the clip pusher bar when a final clip is exhausted.The lock-out bar may prevent the clip pusher bar from returning to thehome position.

The apparatus may further include a clip follower slidably disposedwithin the shaft assembly at a location proximal of the plurality ofclips. In use, the clip follower may urge the lock-out bar of thepusher-bar latch mechanism into engagement with the clip pusher bar whenthe final clip is exhausted.

The lockout system may include a rack having a plurality of ratchetteeth and being secured to the drive channel; and a pawl having at leastone tooth and being disposed at a location to selectively engage therack. The pawl may be biased into engagement with the rack. In use, asthe drive channel is longitudinally reciprocated, the plurality of teethmay be passed over the pawl, and the pawl may prevent inadvertent returnof the drive channel before full actuation of the apparatus.

The apparatus lockout system may include a latch member operativelyengageable by the clip pusher bar and the drive channel. The latchmember may include a position that is out of engagement with the drivechannel when the clip pusher bar is in the home position, and a positionthat is engaged with the drive channel when the clip pusher bar is in anon-home position. In use, when the clip pusher bar is prevented fromreturning to the home position by the lock-out bar, the latch member isengaged with the drive channel and prevents the drive channel frommoving proximally, whereby the plurality of teeth of the rack aremaintained in engagement with the pawl.

The apparatus may further include a wedge plate slidably supported inthe shaft assembly. The wedge plate may include a distal end configuredand dimensioned for placement between the jaw members when the jawmembers are in the spaced-apart position. In use, the wedge plate may bemoved in a proximal direction to withdraw the distal end thereof frombetween the jaw members when the drive channel is moved in a distaldirection.

The apparatus may further include a gear operatively disposed betweenthe wedge plate and the drive channel. In use, the gear may translatedistal movement of the drive channel into proximal movement of the wedgeplate and proximal movement of the drive channel into distal movement ofthe wedge plate.

The apparatus may be provided with a delay between the distaladvancement of the drive bar and the distal advancement of the drivechannel.

The apparatus may further include a trip mechanism supported on thedrive bar. The trip mechanism may include a trip lever biased intocontact with the clip pusher bar. In use, distal movement of the drivebar may move the trip mechanism until the trip lever thereof engages alip of the clip pusher bar and in turn distally moves the clip pusherbar.

The apparatus may further include a shear pin operatively connected tothe drive bar to transmit axial forces to the drive bar during movementof the trigger, wherein the shear pin includes at least one region ofreduced strength. The shear pin may fail at the at least one region ofreduced strength when a minimum predetermined shear force is exerted onthe shear pin.

According to another aspect of the present disclosure, an apparatus forapplication of surgical clips to body tissue is provided and includes ahandle assembly; a shaft assembly extending distally from the handleassembly; a plurality of surgical clips disposed within the shaftassembly, wherein each clip has an outer width; and jaws mountedadjacent a distal end portion of the shaft assembly, wherein the jawsinclude a pair of jaw members movable between a spaced-apart and anapproximated position. The pair of jaw members have an outer width whenin the spaced-apart position.

According to yet another aspect of the present disclosure, an apparatusfor application of surgical clips to body tissue is provided. Theapparatus includes a) a handle assembly; b) a shaft assembly extendingdistally from the handle assembly; c) a plurality of surgical clipsdisposed within the shaft assembly, each clip having an outer width; andd) jaws mounted adjacent a distal end portion of the shaft assembly, thejaws including a pair of jaw members movable between a spaced-apart andan approximated position, wherein when the pair of jaw members are inthe spaced-apart position the pair of jaw members have an outer width,wherein a ratio of the outer width of the clip to the outer width of thepair of jaw members when in the spaced-apart position in less than orequal to 1:1.8.

According to still another aspect of the present disclosure, a method ofapplying surgical clips from a surgical clip applier is provided. Themethod includes the step of providing a surgical clip applier comprisingat least a plurality of clips, jaws configured to receive and form saidclips, and a trigger configured to actuate the jaws between an openposition for receiving said clips and a closed position for forming saidclips. The method further includes the steps of actuating the triggerfrom an open position to a closed position to load a first clip into thejaws and to move the jaws from the open position to the closed positionto form said first clip; and then releasing the trigger to return thetrigger to the open position and to return the jaws to the openposition.

The trigger can only return to the open position after the trigger hasbeen actuated to a fully closed position. The method may furthercomprise the step of providing a drive bar connected to the trigger, andwherein the step of actuating the trigger from the open position to theclosed position may then cause the drive bar to move distally.

The method may further comprise the step of providing a pusher barselectively connected to the drive bar, and wherein the step ofactuating the trigger from the open position to the closed position maythen cause the pusher bar to move distally.

The step of moving the pusher bar distally may include the step of adistal end of the pusher bar contacting a backspan of a distalmost clipand then moving the distalmost clip to a position between into the jaws.The method may further comprise the step of then disengaging the drivebar from the pusher bar, whereby the drive bar continues to movedistally.

The method may further comprise the step of simultaneously moving aremainder of clips in a distal direction as said distalmost clip ismoved into the jaws.

The method may further comprise the step of the drive bar then engaginga drive channel to move the drive channel in a distal direction.

The method may further comprise the step of then moving the pusher barin a proximal direction.

The method may further comprise the step of then moving a wedge plate ina proximal direction such that a distal end of the wedge plate iswithdrawn from between the jaws.

The method may further comprise the step of then engaging a distal endof the drive channel against the jaws to move the jaws from the openposition to the closed position to form the clip disposed therein.

The method may further comprise the step of actuating a countermechanism to indicate that an event has occurred.

The method may further comprise the step of then releasing the triggerto move the drive bar and drive channel in a proximal direction and tomove the wedge plate in a distal direction.

The method may further comprise the step of actuating a lock member,following placement of a final clip into the jaws, that engages thepusher bar and prevents the pusher bar from moving to a fully proximalposition.

BRIEF DESCRIPTION OF THE DRAWINGS

A particular embodiment of a surgical clip applier is disclosed hereinwith reference to the drawings wherein:

FIG. 1 is a perspective view of a surgical clip applier;

FIG. 2 is a further perspective view of the surgical clip applier ofFIG. 1, illustrating a rotation of an elongate tubular member thereof;

FIG. 3 is an enlarged, perspective view of the jaw structure of thesurgical clip applier of FIGS. 1 and 2;

FIG. 4A is a top view of a surgical clip applier having a first overalllength;

FIG. 4 is a top view of the surgical clip applier of FIGS. 1-3, having asecond overall length;

FIG. 5 is a side view of the surgical clip applier of FIGS. 1-4;

FIG. 6 is a left-side, perspective view of a handle assembly of thesurgical clip applier of FIGS. 1-4, with a half of the body removedtherefrom;

FIG. 7 is a right-side, perspective view of a handle assembly of thesurgical clip applier of FIGS. 1-4, with a half of the body removedtherefrom;

FIG. 8 is an exploded, perspective view of the handle assembly of thesurgical clip applier of FIGS. 1-4, and a perspective view of a shaftassembly of the surgical clip applier of FIGS. 1-4 shown operativelyassociated therewith;

FIG. 9 is an exploded, perspective view of the shaft assembly of thesurgical clip applier of FIGS. 1-4;

FIG. 10 is a perspective view of a tactile feedback member of thesurgical clip applier of FIGS. 1-4;

FIG. 11 is an exploded, perspective view of the indicated area of detailof FIG. 9, illustrating a trip mechanism of the shaft assembly;

FIG. 12 is an exploded, perspective view of the indicated area of detailof FIG. 9, illustrating a latch lock-out of the shaft assembly;

FIG. 13 is a perspective view of the indicated area of detail of FIG. 9,illustrating a joint slider the shaft assembly;

FIG. 14 is an exploded, perspective view of the indicated area of detailof FIG. 9, illustrating a pusher-bar latch mechanism of the shaftassembly;

FIG. 15 is an exploded, perspective view of the indicated area of detailof FIG. 9, illustrating a wedge plate rack mechanism of the shaftassembly;

FIG. 16 is a partially exploded, perspective view of a proximal end ofthe surgical clip applier of FIGS. 1-4, illustrating a joint extensiondisposed between the shaft assembly and the handle assembly;

FIG. 17 is an assembled, perspective view of a proximal end of thesurgical clip applier of FIG. 16, illustrating a joint extensiondisposed between the shaft assembly and the handle assembly;

FIG. 18 is a rear, perspective, cross-sectional view of the surgicalclip applier of FIGS. 1-4, as taken through 18-18 of FIG. 5;

FIG. 19 is an enlarged view of the indicated area of detail of FIG. 18;

FIG. 20 is a rear, elevational, cross-sectional view of the surgicalclip applier of FIGS. 1-4, as taken through 20-20 of FIG. 5;

FIG. 21 is a front, perspective view of the shaft assembly of thesurgical clip applier of FIGS. 1-4, with an outer tubular member removedtherefrom for illustrative purposes;

FIG. 22 is an enlarged, perspective view of the indicated area of detailof FIG. 21;

FIG. 23 is an enlarged, perspective view of the indicated area of detailof FIG. 21;

FIG. 24 is a front, perspective view of the shaft assembly of thesurgical clip applier of FIGS. 1-4, with an upper housing removedtherefrom for illustrative purposes;

FIG. 25 is an enlarged, perspective view of the indicated area of detailof FIG. 24;

FIG. 26 is an enlarged, perspective view of the indicated area of detailof FIG. 24;

FIG. 27 is an enlarged, perspective view of a distal end of the shaftassembly of FIG. 24;

FIG. 28 is a rear, perspective view of the shaft assembly of thesurgical clip applier of FIGS. 1-4, with a pusher bar, a clip advancemechanism and a plurality of clips removed therefrom;

FIG. 29 is an enlarged, perspective view of the indicated area of detailof FIG. 28;

FIG. 30 is an enlarged, perspective view of the indicated area of detailof FIG. 28;

FIG. 31 is a front, perspective view of the shaft assembly of thesurgical clip applier of FIGS. 1-4, with a lower housing pusher bar, aclip advance mechanism and a plurality of clips removed therefrom;

FIG. 32 is an enlarged, perspective view of the indicated area of detailof FIG. 31;

FIG. 33 is a perspective view of the indicated area of detail of FIG.31;

FIG. 34 is a bottom, front, perspective view of the shaft assembly ofthe surgical clip applier of FIGS. 1-4, with a lower housing removedtherefrom;

FIG. 35 is an enlarged, perspective view of the indicated area of detailof FIG. 34;

FIG. 36 is an enlarged, perspective view of the indicated area of detailof FIG. 34;

FIG. 37 is a rear, perspective view of the shaft assembly of thesurgical clip applier of FIGS. 1-4, with a drive channel and wedge plateremoved therefrom;

FIG. 38 is an enlarged, perspective view of the indicated area of detailof FIG. 34;

FIG. 39 is a bottom, front, perspective view of the distal end of theshaft assembly of the surgical clip applier of FIGS. 1-4, illustratingthe upper housing, the wedge plate and a drive channel in an assembledcondition;

FIG. 40 is an enlarged, rear perspective view of a pawl and rackassembly of the shaft assembly with the drive bar removed;

FIG. 41 is an enlarged, perspective view of the indicated area of detailof FIG. 39;

FIG. 42 is an enlarged, perspective view of the indicated area of detailof FIG. 39;

FIG. 43 is a bottom, front, perspective view of the distal end of theshaft assembly of FIG. 39, with the wedge plate and the drive channel,clip stack and follower removed therefrom;

FIG. 44 is an enlarged, perspective view of the indicated area of detailof FIG. 43;

FIG. 45 is an enlarged, perspective view of the indicated area of detailof FIG. 43;

FIG. 46 is an enlarged, perspective view of the indicated area of detailof FIG. 43;

FIG. 47 is a longitudinal, elevational, cross-sectional view of thesurgical clip applier of FIGS. 1-4;

FIG. 48 is an enlarged, elevational, cross-sectional view of theindicated area of detail of FIG. 47;

FIG. 49 is an enlarged, elevational, cross-sectional view of theindicated area of detail of FIG. 47;

FIG. 50 is a longitudinal, cross-sectional view as taken through 50-50of FIG. 49;

FIG. 51 is a transverse, cross-sectional view as taken through 51-51 ofFIG. 48;

FIG. 52 is an enlarged, elevational, cross-sectional view of theindicated area of detail of FIG. 49;

FIG. 53 is a longitudinal, cross-sectional view taken through 53-53 ofFIG. 52;

FIG. 54 is an enlarged, elevational, cross-sectional view of theindicated area of detail of FIG. 49;

FIG. 55 is a longitudinal, cross-sectional view taken through 55-55 ofFIG. 54;

FIG. 56 is an enlarged, elevational, cross-sectional view of theindicated area of detail of FIG. 49;

FIG. 57 is a longitudinal, cross-sectional view taken through 57-57 ofFIG. 56;

FIG. 58 is a transverse, cross-sectional view as taken through 58-58 ofFIG. 54;

FIG. 59 is a transverse, cross-sectional view as taken through 59-59 ofFIG. 56;

FIG. 60 is an enlarged, elevational, cross-sectional view of theindicated area of detail of FIG. 49;

FIG. 61 is a longitudinal, cross-sectional view taken through 61-61 ofFIG. 60;

FIG. 62 is a longitudinal, elevational, cross-sectional view of thesurgical clip applier of FIGS. 1-4, illustrating a first stage of aninitial stroke of the trigger of the handle assembly;

FIG. 63 is an enlarged, elevational, cross-sectional view of the ofdetail 52 of FIG. 49, during the first stage of the initial stroke ofthe trigger of the handle assembly;

FIG. 64 is a longitudinal, cross-sectional view taken through 64-64 ofFIG. 63;

FIGS. 65 and 66 are enlarged, elevational, cross-sectional views ofdetail 60 of FIG. 49, during the first stage of the initial stroke ofthe trigger of the handle assembly;

FIG. 67 is a longitudinal, elevational, cross-sectional view of thesurgical clip applier of FIGS. 1-4, illustrating a second stage of aninitial stroke of the trigger of the handle assembly;

FIG. 68 is an enlarged, elevational, cross-sectional view of theindicated area of detail of FIG. 67, during the second stage of theinitial stroke of the trigger of the handle assembly;

FIG. 69 is an enlarged, elevational, cross-sectional view of detail 60of FIG. 49, during the second stage of the initial stroke of the triggerof the handle assembly;

FIG. 70 is an enlarged, elevational, cross-sectional view of detail 52of FIG. 49, during the second stage of the initial stroke of the triggerof the handle assembly;

FIG. 71 is an enlarged, elevational, cross-sectional view of detail 54of FIG. 49, during the second stage of the initial stroke of the triggerof the handle assembly;

FIG. 72 is a longitudinal, cross-sectional view taken through 72-72 ofFIG. 71;

FIG. 73 is an enlarged, elevational, cross-sectional view of detail 52of FIG. 49, during the second stage of the initial stroke of the triggerof the handle assembly;

FIGS. 74 and 75 are enlarged, elevational, cross-sectional views ofdetail 60 of FIG. 49, during the second stage of the initial stroke ofthe trigger of the handle assembly;

FIG. 76 is an enlarged, elevational, cross-sectional view of the ofdetail 52 of FIG. 49, during the second stage of the initial stroke ofthe trigger of the handle assembly;

FIG. 77 is an enlarged, elevational, cross-sectional view of the detail56 of FIG. 49, during the second stage of the initial stroke of thetrigger of the handle assembly;

FIG. 78 is a longitudinal, cross-sectional view taken through 78-78 ofFIG. 77;

FIG. 79 is a front, perspective view of the jaws of the surgical clipapplier having the wedge plate interposed therebetween;

FIG. 80 is a front, perspective view of the jaws of the surgical clipapplier illustrating the wedge plate being withdrawn from therebetween;

FIG. 81 is a longitudinal, elevational, cross-sectional view of thehandle assembly of the surgical clip applier of FIGS. 1-4, illustratinga third stage of an initial stroke of the trigger of the handleassembly;

FIG. 82 is an enlarged, elevational, cross-sectional view of theindicated area of detail of FIG. 81;

FIG. 83 is an enlarged, elevational, cross-sectional view of theindicated area of detail of FIG. 81;

FIG. 84 is a rear, perspective, partial cross-sectional view of thehandle assembly during the third stage of the initial stroke of thetrigger of the handle assembly;

FIG. 85 is an enlarged, elevational, cross-sectional view of detail 54of FIG. 49, during third stage of the initial stroke of the trigger ofthe handle assembly;

FIG. 86 is a longitudinal, cross-sectional view taken through 86-86 ofFIG. 85;

FIG. 87 is a front, perspective view of the jaws of the surgical clipapplier illustrating a drive channel and a drive plate operativelyassociated therewith;

FIG. 88 is a longitudinal, top-plan, cross-sectional view of a distalend of the shaft assembly of the surgical stapling device of FIGS. 1-4,illustrating an un-approximated position of the jaws;

FIG. 89 is a longitudinal, top-plan, cross-sectional view of a distalend of the shaft assembly of the surgical stapling device of FIGS. 1-4,illustrating an approximated position of the jaws;

FIG. 90 is a perspective view of the body vessel including a clip of thesurgical stapling device of FIGS. 1-4, applied thereto;

FIG. 91 is a longitudinal, cross-sectional view taken through 64-64 ofFIG. 63, illustrating an operation the pawl and rack assembly of FIG.40;

FIGS. 92 and 93 are enlarged, elevational, cross-sectional views ofdetail 83 of FIG. 81, illustrating the operation of the tactile feedbackelement;

FIG. 94 is a longitudinal, cross-sectional view taken through 64-64 ofFIG. 63, illustrating a further operation a pawl and rack assembly;

FIG. 95 is a longitudinal, elevational, cross-sectional view of thehandle assembly of the surgical clip applier of FIGS. 1-4, illustratinga release stroke of the trigger of the handle assembly;

FIG. 96 is an enlarged, elevational, cross-sectional view of detail 54of FIG. 49, during the release stoke of the trigger of the handleassembly;

FIG. 97 is a longitudinal, top-plan, cross-sectional view of a distalend of the shaft assembly of the surgical stapling device of FIGS. 1-4,illustrating the un-approximation of the jaws during the release stokeof the trigger of the handle assembly;

FIG. 98 is a longitudinal, cross-sectional view taken through 78-78 ofFIG. 77, illustrating the operation of the wedge plate rack mechanismduring the release stoke of the trigger of the handle assembly;

FIG. 99 is a rear, perspective view of the jaws of the surgical clipapplier illustrating the wedge plate being inserted therebetween;

FIG. 100 is an enlarged, elevational, cross-sectional view of detail 60of FIG. 49, beginning a lockout phase after the final clip has beenfired;

FIG. 101 is an enlarged, elevational, cross-sectional view of the ofdetail 52 of FIG. 49, during the release stroke of the trigger of thehandle assembly and engaging a lockout mechanism;

FIG. 102 is a longitudinal, cross-sectional view of FIG. 64,illustrating an operation a pawl and rack assembly during the lockoutphase of the device;

FIG. 103 is an enlarged, longitudinal, cross-sectional view of thehandle assembly, illustrating the operation of a drive assembly afterthe lockout mechanism has been engaged; and

FIG. 104 is an enlarged, longitudinal, cross-sectional view of thehandle assembly, illustrating the operation of a shear pin with thedrive assembly breaking through the lockout mechanism.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of surgical clip appliers in accordance with the presentdisclosure will now be described in detail with reference to the drawingfigures wherein like reference numerals identify similar or identicalstructural elements. As shown in the drawings and described throughoutthe following description, as is traditional when referring to relativepositioning on a surgical instrument, the term “proximal” refers to theend of the apparatus which is closer to the user and the term “distal”refers to the end of the apparatus which is further away from the user.

Referring now to FIGS. 1-5, a surgical clip applier in accordance withan embodiment of the present disclosure is generally designated as 100.Surgical clip applier 100 generally includes a handle assembly 102 andan endoscopic portion including a shaft assembly 104 extending distallyfrom handle assembly 102.

Shaft assembly 104 may have various outer diameters such as, forexample, about 5 mm or about 10 mm, depending on intended use. Further,shaft assembly 104 may have various elongated (see FIG. 4A) or shortenedlengths (see FIGS. 4 and 5) depending on intended use, such as, forexample, in bariatric surgery. In one embodiment, in bariatric surgery,elongated tubular member 104 may have a length of between about 30 cmand about 40 cm. However one skilled in the art should appreciate thatshaft assembly 104 may have any length in excess of about 30 cm and thepresent disclosure is not limited to any of the above identifiedlengths.

Surgical clip applier 100 includes a pair of jaws 106 mounted on adistal end of shaft assembly 104 and actuatable by a trigger 108 ofhandle assembly 102. Jaws 106 are formed of a suitable biocompatiblematerial such as, for example, stainless steel or titanium. Notably, insome embodiments, when jaws 106 are in an open or un-approximatedcondition relative to each other, a maximum width of jaws 106 measuressubstantially less than or equal to an outer diameter of shaft assembly104 to allow for insertion of a distal end of surgical clip applier 100through a trocar during endoscopic surgery or an opening or orifice in abody during open surgery.

Jaws 106 are mounted in the distal end of shaft assembly 104 such thatthey are longitudinally stationary relative thereto. A knob 110 may berotatably mounted on a distal end of handle assembly 102 and affixed toshaft assembly 104 to transmit and/or provide 360° rotation to shaftassembly 104 and jaws 106 about a longitudinal axis thereof (see FIG.2). Referring momentarily to FIG. 3, jaws 106 define a channel 106 atherebetween for receipt of a surgical clip (not shown) therein.

Referring now to FIGS. 6-8, handle assembly 102 of surgical clip applier100 is shown. Handle assembly 102 includes a housing 103 having a firstor right side half-section 103 a and a second or left side half-section103 b. Handle assembly 102 includes a trigger 108 pivotably supportedbetween right side half-section 103 a and left side half-section 103 b.Handle assembly 102 defines a window 103 c formed in housing 103 forsupporting and displaying a counter mechanism 132 a, as will bediscussed in greater detail below. Housing 103 of handle assembly 102may be formed of a suitable plastic material.

Housing 103 supports a drive assembly 120 between right sidehalf-section 103 a and left side half-section 103 b. Drive assembly 120includes a wishbone link 122 having a first end pivotally connected totrigger 108, and a second end pivotally connected to a yoke 124. As seenin FIGS. 6-9, drive assembly 120 further includes a plunger 134rotatably connected to yoke 124, and a spring 136 supported on plunger134. Plunger 134 defines a longitudinal slot 134 a (see FIG. 9)configured and adapted to receive a proximal end of a drive bar 140therein.

Drive bar 140 is pinned to plunger 134 via a shear pin 142, thestructure and function of which will be described in greater detailbelow. A cap 144 is provided through which drive bar 140 extends. A knobinsert 111 is provided and is configured and adapted for rotationalsupport in a distal end of housing 103 and for support of cap 144therewithin. Knob insert 111 is keyed to knob 110 such that rotation ofknob 110 results in concomitant rotation of knob insert 111. A seal 146is provided to create an air-tight seal between drive bar 140 and anouter tube 150.

As seen in FIGS. 6-8, 48, 62, 67, 81, 83, 84, 92, 93 and 95, handleassembly 102 further includes an audible/tactile feedback member 126operatively associated with trigger 108 so as to rotate together withand about a common axis as trigger 108. Feedback member 126 includes adeflectable arm 126 a. In operation, as trigger 108 is actuated, arm 126a of feedback member 126 rides over and/or along a rib 103 d formed inat least one of right side half-section 103 a and left side half-section103 b. As will be discussed in greater detail below, as arm 126 areaches the end of rib 103 d, arm 126 a snaps over the end of rib 103 dand creates and audible sound/click and/or a tactile vibration as arm126 a comes into contact with a surface 103 f of right side half-section103 a and left side half-section 103 b.

As seen in FIGS. 6-8, housing 103 further supports an actuator plate 128on right side half-section 103 a. Actuator plate 128 includes aprotrusion 128 a configured and adapted for slidable engagement in aslot 103 e defined in right side half-section 103 a of housing 103.Actuator plate 128 defines a longitudinally oriented slot 128 b thereinfor slidably receiving a boss 122 a of wishbone link 122. Actuator plate128 further defines a counter actuation surface 128 c for slidablyengaging an arm 130 b of a counter actuation lever 130. Counteractuation lever 130 is pivotally supported within housing 103.

As seen in FIGS. 6-8, 48, 62, 67, 81, 82, and 95, counter actuationlever 130 includes a first arm 130 a configured and adapted tooperatively, selectively engage a counter mechanism 132 supported inhousing 103 and visible through window 103 c defined in housing 103.Counter actuation lever 130 further includes a second arm 130 bconfigured and adapted to operatively, slidably engage actuation surface128 c of actuation plate 128. A biasing member, in the form of a spring139, is provided to bias second arm 130 b of counter actuation lever 130against counter actuation surface 128 c of actuator plate 128.

In operation, as will be described in greater detail below, as trigger108 is squeezed, trigger 108 causes wishbone link 122 to be advanceddistally, causing yoke 124 to be advanced distally. When boss 122 a ofwishbone link 122 reaches the end of slot 128 b of actuator plate 128,boss 122 a forces actuator plate 128 in a distal direction therebyactuating counter actuation lever 130 to activate counter mechanism 132.In particular, when actuator plate 128 is moved distally a sufficientdistance, second arm 130 b of counter actuation lever 130 clears counteractuation surface 128 c of actuator plate 128 and is urged in a first orclockwise direction by spring 139 resulting in first arm 130 a ofcounter actuation lever 130 engaging counter mechanism 132. Whenactuator plate 128 is moved proximally a sufficient distance, second arm130 b of counter actuation lever 130 is cammed by counter actuationsurface 128 c of actuator plate 128 and is urged in a second orcounter-clockwise direction thereby resulting in first arm 130 a ofcounter actuation lever 130 disengaging counter mechanism 132.

Counter mechanism 132 includes a display 132 a, a processor 132 b, andan energy source 132 c in the form of a battery or the like.

Display 132 a may be any device known in the art to provide anindication of an event. The event may be related to the procedure or theoperation of the clip applier 100. Display 132 a may be a liquid crystaldisplay (LCD), a plasma display, one or more light emitting diodes(LEDs), a luminescent display, a multi-color display, a digital display,an analog display, a passive display, an active display, a so called“twisted nematic” display, a so called “super twisted nematic” display,a “dual scan” display, a reflective display, a backlit display, an alphanumeric display, a monochrome display, a so called “Low TemperaturePolysilicon Thin Film Transistor” (LPTS TFT) display, or any othersuitable display 132 a that indicates a parameter, information orgraphics related to the procedure or clip applier 100.

In one embodiment, display 132 a is a liquid crystal display which maybe a black & white or color display that displays one or more operatingparameters of clip applier 100 to the surgeon. In one embodiment, theoperating parameter displayed may be an amount or number of remainingclips, a number of clips that have been used, a position parameter, asurgical time of usage, or any other parameter of the procedure. Thedisplay 132 a may display text, graphics or a combination thereof.

In one embodiment, counter mechanism 132 may have a tab, preferably madefrom a Mylar or another polymeric insulating material, disposed betweenbattery or energy source 132 c and a contact of processor 132 b whichprevents the battery or energy source 132 c from becoming drained duringstorage. The tab may extend out of housing 103 of surgical clip applier100 in order to allow for easy removal of the tab therefrom. Once thetab is removed, battery or energy source 132 c comes into electricalcontact with the contact of processor 132 b and in turn energizesdisplay 132 a.

Display 132 c may include a lens or the like for magnifying theparameters displayed thereon. The lens of display 132 a may magnify thedisplay to any desired size in order to allow a surgeon to read thedisplay with ease from a distance.

In an embodiment, counter mechanism may be a digital counter including alight source and an optical sensor for cooperating with the lightsource. The optical sensor may include an electronic eye or fiber opticlead producing a constant infrared beam that is shown on a detector suchthat the infrared beam or an interruption of the infrared beam can betranslated into an electrical signal.

Turning now to FIGS. 9-46, shaft assembly 104 of surgical clip applier100 is shown and described hereinbelow. Shaft assembly 104 and thecomponents thereof may be formed of suitable biocompatible materials,such as, for example, stainless steel, titanium, plastics and the like.Shaft assembly 104 includes an outer tube 150 having a proximal end 150a supported within knob insert 111, a distal end 150 b, and a lumen 150c extending therethrough. Shaft assembly 104 further includes an upperhousing 152 a and a lower housing 152 b, each disposed within lumen 150c of outer tube 150. Outer tube 150 is secured within knob insert 111 byprotrusions 111 c extending from inner surface of knob insert 111 a, 111b and engaging holes 150 d formed in outer tube 150 (see FIG. 9). A tripblock 154 is disposed within outer tube 150 and proximal of upperhousing 152 a. As seen in FIGS. 43 and 45, trip block 154 includes awindow 154 a formed in an upper surface thereof.

Shaft assembly 104 further includes a pusher bar 156 slidably interposedbetween outer tube 150, and upper housing 152 a and trip block 154.Pusher bar 156 includes a distal end 156 a defining a pusher 156 cconfigured and adapted to selectively enter into a window 153 a formedin upper housing 152 a (see FIGS. 21 and 22) and engage/move (i.e.,distally advance) clips stored in surgical clip applier 100. Pusher bar156 further includes a proximal end 156 b operatively secured to tripblock 154 (see FIGS. 21 and 23). Pusher bar 156 defines a distal window156 d and a proximal window 156 e.

As seen in FIG. 23, pusher bar 156 is biased to a proximal position,relative to trip block 154, by a biasing element 158, such as forexample a compression spring, interposed between a boss 154 a extendingfrom trip block 154 and a surface of pusher bar 156. In an embodiment,as seen in FIG. 23, spring 158 is supported on a tine 156 f formed in awindow 156 g of pusher bar 156, wherein a distal end of tine 156 fslidably extends through boss 154 a of trip block 154. Spring 158 isdisposed between a base of tine 156 f and stem 154 a of trip block 154.

As best seen in FIGS. 9, 12, 43 and 44, shaft assembly 104 furtherincludes a latch lock-out 160 operatively supported within a channel 154b (see FIG. 44) defined in an underside of trip block 154. Latchlock-out 160 includes a latch member 162 pivotally supported in channel154 b of trip block 154, and a biasing member 164 securely connectedwithin channel 154 b of trip block 154 and operatively connected tolatch member 162 so as to bias latch member 162, in a counter-clockwisedirection as shown, to a first condition. Latch member 162 includes adistal portion 162 a defining a shoulder and a proximal portion 162 bdefining a rounded surface 162 b. Biasing member 164 includes an arm 164a in contact with and acting on distal portion 162 a of latch member 162to force distal portion 162 a of latch member 162 radially inward (i.e.,towards or in a counter-clockwise direction as shown) and likewise toforce proximal portion 162 b of latch member 162 radially outward (i.e.,away or in a counter-clockwise direction as shown).

As best seen in FIGS. 9, 14, 43 and 46, shaft assembly 104 furtherincludes a pusher-bar latch mechanism 166 operatively supported within achannel 153 b (see FIG. 46) defined in an underside of upper housing 152a. Pusher-bar latch mechanism 166 includes a lock-out bar 168 pivotallysupported in channel 153 b of upper housing 152 a, and a biasing member170 securely connected within channel 153 b of upper housing 152 b andoperatively connected to lock-out bar 168 so as to bias lock-out bar168, in a clockwise direction as shown, to a first condition. Lock-outbar 168 includes a distal portion 168 a operatively connected to biasingmember 170, and a proximal portion 168 b defining a catch. Biasingmember 170 includes a proximal portion 170 b in contact with and actingon distal portion 168 a of lock-out bar 168 to force distal portion 168a of lock-out bar 168 radially outward (i.e., away from lower housing152 b or in a clockwise direction as shown) and likewise to forceproximal portion 168 b of lock-out bar 168 radially inward (i.e., towardlower housing 152 b or in a clockwise direction as shown).

As seen in FIGS. 27 and 46, a distal portion 170 a of biasing member 170is received in an aperture formed in a retention plate 172. Retentionplate 172 is operatively supported in channel 153 b of upper housing 152a and includes a pair of spaced apart, resilient, distal tangs 172 a.Tangs 172 a of retention plate 172 are configured and adapted toselectively engage a backspan of a distal-most surgical clip “C1” (notshown in FIG. 46) of a stack of surgical clips “C” retained withinsurgical clip applier 100.

As seen in FIGS. 9, 24, 25 and 27, a stack of surgical clips “C” isloaded and/or retained within channel 153 b of upper housing 152 a in amanner so as to slide therewithin and/or therealong. As mentioned above,a distal-most surgical clip “C1” of the stack of surgical clips “C” isselectively held in position by tangs 172 a of retention plate 172.

Shaft assembly 104 further includes a clip follower 180 slidablysupported and/or retained within channel 153 b of upper housing 152 a.Clip follower 180 includes a head portion 180 a disposed behind and incontact with a proximal-most surgical clip “C2” of the stack of surgicalclips “C”. Clip follower 180 further includes a tail portion 180 bextending in a proximal direction from head portion 180 a. Head portion180 a defines a ramp 180 c near a proximal end thereof. In operation, aswill be discussed in greater detail below, as clip follower 180 isdistally advanced, head portion 180 a thereof will contact and engagelock-out bar 168 of pusher-bar latch mechanism 166 such that distalportion 168 b of lock-out bar 168 is cammed or urged in a radiallyoutward direction (i.e., toward upper housing 152 a or in acounter-clockwise direction as shown) by ramp 180 c of head portion 180a of clip follower 180.

A biasing member in the form of a compression spring 182 is disposedabout tail portion 180 b of clip follower 180. Biasing member 182functions to bias clip follower 180 in a distal direction, therebyapplying a distally oriented force on the stack of clips “C”. Retainerblock 184 includes a flange 184 b interposed between upper housing 152 aand trip block 154.

As seen in FIGS. 9 and 24-26, shaft assembly 104 further includes a clipretainer plate 186 configured and adapted to under/overlie the stack ofsurgical clips “C”, clip follower 180 and at least a portion of retainerblock 184. As best seen in FIG. 27, clip retainer plate 186 includes aramp 186 a formed near a distal end thereof. As will be described ingreater detail below, ramp 186 a of clip retainer plate 186 functions toengage a backspan of distal-most clip “C1” as distal-most clip “C1” isbeing advanced by pusher bar 156. Clip retainer plate 186 snap-fitand/or press-fit engages into channel 153 b of upper housing 152 autilizing tabs 186 b engaged with elements 153 j (see FIG. 9).

As seen in FIGS. 9, 27, 31-35, 39, 41 and 42, shaft assembly 104 furtherincludes a wedge plate 188 under/overlying clip retainer plate 186.Wedge plate 188 includes a substantially tapered distal end 188 a forselective operative interposition between jaws 106. As seen in FIGS. 33and 42, wedge plate 188 defines a fin or tab 188 b projecting from alower surface thereof.

As seen in FIGS. 9, 28-30, 34, 35, 39, 41 and 42, shaft assembly 104further includes a drive channel 190 positioned adjacent wedge plate188. Drive channel 190 includes a pair of side walls 190 a dependingfrom a backspan 190 b thereof, in a direction away from wedge plate 188and into a channel 153 c defined by lower housing 152 b. Drive channel190 further includes a tab 190 c extending from backspan 190 b, in thedirection of side walls 190 a (see FIGS. 39 and 41), an elongate slot190 d formed in backspan 190 b (see FIGS. 39 and 42), and a cut-out 190e formed in one of side walls 190 a (see FIGS. 39 and 42).

As seen in FIGS. 9, 11, 24, 26, 28, 29, 31, 37 and 38, and as describedabove, shaft assembly 104 includes a drive bar 140 having a proximal end140 b extending into handle assembly 102, and distal end 140 a extendingbelow and/or adjacent to a proximal end of wedge plate 188. Drive bar140 includes a goose-neck 140 c (see FIG. 11) such that distal end 140 athereof is on/in a different plane than proximal end 140 b thereof, andsuch that at least a portion of distal end 140 a underlies or isadjacent to drive channel 190. Distal end 140 a of drive bar 140 definesan elongate slot 140 d formed therein. Distal end 140 a of drive bar 140further includes a stop 140 h formed therein at a location proximal ofslot 140 d and extending in a direction away from lower housing 152 b.Proximal end 140 b of drive bar 140 includes formations and/or structure140 f (see FIG. 11) configured and adapted to support and/or otherwiseretain trip mechanism 192 thereon.

As seen in FIGS. 9, 11, 24, 26 and 43, shaft assembly 104 furtherincludes a trip mechanism 192 supported in proximal end 140 b of drivebar 140, in the manner described above. In particular, trip mechanism192 includes a trip block 194 configured and adapted for retention in orsupport on formations and/or structure 140 f of drive bar 140, and atrip lever 196 pivotally connected to trip block 194. Trip mechanism 192further includes a biasing member 198, in the form of a compressionspring, interposed between trip block 194 and a free end of trip lever196, for biasing the free end of trip lever 196 in a direction (i.e.,clockwise as shown) toward trip block 154. As seen in FIG. 11, triplever 196 defines a catch 196 a formed along an upper surface thereof.

As seen in FIGS. 9, 13, 34, 37 and 38, shaft assembly 104 furtherincludes a slider joint 200 slidably interposed between channel 153 c oflower housing 152 b and distal end 140 a of drive bar 140. Slider joint200 includes a body portion 202 and a rod 204 extending therefrom. Whenproperly interposed between channel 153 c of lower housing 152 b anddistal end 140 a of drive bar 140, rod 204 of slider joint 200 extendsin a substantially distal direction. Rod 204 of slider joint 200 isslidably passed through a stub 153 d formed in and extending fromchannel 153 c of lower housing 152 b (see FIG. 38). Shaft assembly 104further includes a biasing member 206, in the form of a compressionspring, supported on rod 204 and interposed between stub 153 d of lowerhousing 152 b and body portion 202 of slider joint 200.

Body portion 202 of slider joint 200 includes a tab 202 a formed near aproximal end thereof, and configured and adapted for slidably engagementin elongate slot 140 d of drive bar 140 (see FIGS. 37 and 38). Bodyportion 202 of slider joint 200 further includes a pocket 202 b formednear a distal end thereof, and configured and adapted for receiving tab190 c of drive channel 190 therein (see FIG. 29).

As seen in FIGS. 9, 15, 34, 35 and 37, shaft assembly 104 furtherincludes a wedge plate rack mechanism 210 operatively interposed betweenchannel 153 c of lower housing 152 b and drive channel 190. Wedge platerack mechanism 210 includes a wedge plate rack 212 slidably disposedwithin channel 153 c of lower housing 152 b. Wedge plate rack 212includes a body portion 212 a, a rack 212 b extending distally from bodyportion 212 a, a tail or rod 212 c extending proximally from bodyportion 212 a, a pocket 212 d formed in an upper surface of body portion212 a, and a stem 212 e extending from a bottom surface of body portion212 a.

Stem 212 e of wedge plate rack 212 rides within a groove (not shown)formed in a surface of channel 153 c of lower housing 152 b. Tail or rod212 d of wedge plate rack 212 is slidably passed through a stub 153 eformed in and extending from channel 153 c of lower housing 152 b (seeFIGS. 9 and 37). Wedge plate rack mechanism 210 further includes abiasing member 214, in the form of a compression spring, supported onrod 212 d and interposed between stub 153 e of lower housing 152 b andbody portion 212 a of wedge plate rack 212. As seen in FIG. 33, fin ortab 188 b of wedge plate 188 is disposed within pocket 212 d formed inan upper surface of body portion 212 a of wedge plate rack 212.

Wedge plate rack mechanism 210 further includes a gear 216 pivotallyconnected to lower housing 152 b. Gear 216 includes a set of teeth 216 athat are in operative engagement with rack 212 b of wedge plate rack212, and an opposed tooth 216 b operatively engageable with cut-out 190e formed in one of side walls 190 a of drive channel 190 (see FIG. 35).In operation, as will be discussed in greater detail below, as drivechannel 190 is axially displaced in a distal direction, drive channel190 causes gear 216 to rotate (i.e., in a clockwise direction as shown)and thus causes wedge plate rack 212 to axially move in a proximaldirection, or vice-versa.

As seen in FIGS. 9, 34, 36 and 40, shaft assembly 104 further includes apawl and rack assembly 220 operatively interposed between channel 153 cof lower housing 152 b and proximal end 140 b of drive bar 140. Pawl andrack assembly 220 includes a rack 222 secured to an underside of drivebar 140 (i.e., interposed between proximal end 140 b of drive bar 140and channel 153 c of lower housing 152 b) such that rack 222 is movabletogether with drive bar 140. Rack 222 includes a plurality of teeth 222a interposed between a distal recess 222 b and a proximal recess 222 c(see FIG. 36). Recesses 222 b and 222 c are provided to allow a pawl toreverse and advance back over teeth 222 a of rack 222 when rack 222changes between proximal and distal movement.

Pawl and rack assembly 220 includes a pawl 224 pivotally connected tolower housing 152 b by a pawl pin 226 at a location wherein pawl 224 isin substantial operative engagement with rack 222. Pawl 224 includes apawl tooth 224 a which is selectively engageable with teeth 222 a ofrack 222. Pawl tooth 224 a is engageable with rack teeth 222 b torestrict longitudinal movement of rack 222 and, in turn, drive bar 140within shaft assembly 104 and trigger 108 of handle assembly 102.

Pawl and rack assembly 220 further includes a pawl spring 228 configuredand positioned to bias pawl 224 into operative engagement with rack 222.

As seen throughout the figures and particularly FIGS. 34 and 35, shaftassembly 104 further includes a set of jaws 106 operatively supported ina distal end thereof. Jaws 106 include a proximal section 106 b disposedwithin a distal end of drive channel 190 and a pair of jaw members 106 cextending from the distal end of upper and lower housing 152 a, 152 b.Each jaw member 106 c defines a camming surface 106 d against which adistal edge of drive channel 190 will engage, when drive channel 190 isdistally advanced, to urge jaw members 106 c toward one another. The setof jaws 106 may be configured so as to flex or splay outward in order toreceive and/or accommodate a clip “C” that is wider than an at restinner width distance of jaw members 106 c. In this manner, the set ofjaws 106 have the ability to pass through a 5 mm, 10 mm or fixed sizecannula or trocar and be able to accommodate a relatively wider clip “C”so as to engage a relatively wider vessel “V”.

As best seen from FIGS. 9, 27 and 88, each clip “C” has a pre-formed orun-formed outer width and jaws 106 have a manufactured outer width,wherein the outer width of jaws 106 relative to the outer width of clip“C” results in a ratio approximately less than or equal to 1 to 1.8(e.g., 1:1.8). The ratio may be established or determined when clip “C”is present within jaws 106 or when clip “C” is not present within jaws106.

As seen in FIGS. 9, 34 and 35, shaft assembly 104 further includes asubstantially U-shaped channel 230 disposed within lower housing 152 band operatively connected to a distal end of drive channel 190. U-shapedchannel 230 functions to retain jaw members 106 c in a substantiallyaligned orientation with one another during an operation of surgicalclip applier 100.

As seen in FIGS. 16 and 17, surgical clip applier 100 may include anextension joint housing 232 operatively interposed between upper andlower housings 152 a, 152 b of shaft assembly 104 and handle assembly102. In this manner, surgical clip applier 100 may be modified to use insurgical procedures requiring a greater depth of insertion of jaws 106,such as, for example, in bariatric surgery.

It is contemplated for surgical clip applier 100 to operate with stacksof clips “C” of varying sizes. For example, the clips comprising thestack of clips “C” may have a relatively narrow dimension or arelatively wide dimension.

The operation of surgical clip applier 100, to crimp a surgical cliparound a target tissue, such as, for example, a vessel, will now bedescribed. With reference to FIGS. 47-61, trigger 108 is generally in anuncompressed or unactuated state. As such, yoke 124 of drive assembly120 is in a retracted position and thus, plunger 134 and drive bar 140are also in a retracted position.

As seen in FIG. 52, catch 196 a of trip lever 196 of trip mechanism 192is positioned within window 156 e of pusher bar 156, and latch member162 of latch lock-out 160 is maintained biased by a proximal end ofpusher bar 156. Pusher bar 156 is biased to a proximal-most position bybiasing member 158. Also, as seen in FIG. 53, tooth 224 a of pawl 226 ofpawl and rack assembly 220 is disposed within distal recess 222 b ofrack 222.

As seen in FIGS. 54, 55 and 58, tab 202 a of body portion 202 of sliderjoint 200 is located at a distal-most end of elongate slot 140 d ofdrive bar 140. The length of elongate slot 140 d of drive bar 140defines a dwell “d” of surgical clip applier 100.

As seen in FIGS. 56, 57 and 59, wedge plate 188 is at a distal-mostposition, wedge plate rack 212 of wedge plate rack mechanism 210 is at adistal-most position, and tooth 216 b of gear 216 of wedge plate rackmechanism 210 is disposed within cut-out 190 e formed in one of sidewalls 190 a of drive channel 190.

As seen in FIGS. 60 and 61, distal end 188 a of wedge plate 188 isinterposed between jaw members 106 c of jaws 106. Also, a distal-mostclip “C1” of the stack of clips “C” is held in position by tangs 172 aof retention plate 172. As seen in FIG. 60, proximal portion 168 b oflock-out bar 168 of pusher-bar latch mechanism 166 is disposed beneathpusher bar 156 and is biased as such by biasing member 170.

Turning now to FIGS. 62-66, as trigger 108 is squeezed or actuated fromthe initial position, during a first stage of an initial stroke, asdescribed above, trigger 108 causes wishbone link 122 to move yoke 124in a distal direction which, in turn, causes plunger 134 to movedistally and to move drive bar 140 distally, via shear pin 142. As seenin FIG. 63, as drive bar 140 is moved distally, since catch 196 a oftrip lever 196 of trip mechanism 192 is positioned within window 156 eof pusher bar 156, pusher bar 156 is also moved distally. Simultaneouslytherewith, rack 222 is moved distally causing teeth 222 a thereof tomove over tooth 224 a of pawl 226 and out of distal recess 222 bthereof.

As seen in FIG. 63, distal portion 162 a of latch member 162 of latchlock-out 160 is pivoted into a window 140 g formed in drive bar 140 dueto the urging of arm 164 a of biasing member 164.

As seen in FIGS. 65 and 66, as pusher bar 156 is distally advanced,pusher 156 c thereof engages a backspan of a distal-most clip “C1” andadvances said distal-most clip “C1” over ramp 186 a of clip retainerplate 186 and into channels 106 a of jaw member 106 c of jaws 106.

Turning now to FIGS. 67-80, as trigger 108 is further squeezed oractuated from the first stage of the initial stroke through a secondstage of the initial stroke, as described above, trigger 108 causeswishbone link 122 to further move yoke 124 in a distal direction which,in turn, causes plunger 134 to further move distally and to further movedrive bar 140 distally, via shear pin 142.

As seen in FIGS. 67 and 68, as drive bar 140 is further advanceddistally, drive bar 140 cams against distal portion 162 a of latchmember 162 of latch lock-out 160 and thereby pivots distal portion 162 aof latch member 162 out of window 140 g formed in drive bar 140. As seenin FIGS. 69 and 70, with catch 196 a of trip lever 196 of trip mechanism192 still positioned within window 156 e of pusher bar 156, pusher bar156 is further moved distally. As seen in FIG. 69, as pusher bar 156 isfurther distally advanced, pusher 156 c thereof further advances saiddistal-most clip “C1” into channels 106 a of jaw member 106 c of jaws106.

As seen in FIG. 70, trip lever 196 of trip mechanism 192 is cammed downby camming surfaces 154 b and 154 c of trip block 154, against the biasof biasing member 198, such that catch 196 a of trip lever 196disengages window 156 e of pusher bar 156.

As seen in FIGS. 69 and 71, as distal-most clip “C1” is advanced intojaw members 106 c of jaws 106, the stack of clips “C” is distallyadvanced due to a distal force acting thereon by clip follower 180,which is being urged distally due to a biasing force exerted on headportion 180 a of clip follower 180 by biasing member 182.

As seen in FIG. 72, as drive bar 140 is moved distally, tab 202 a ofbody portion 202 of slider joint 200 is translated through elongate slot140 d of drive bar 140, thereby reducing the length and/or size of dwell“d”. Drive bar 140 is advanced distally until, as seen in FIGS. 71 and72, stop 140 h of drive bar 140 abuts against a proximal-most end ofdrive channel 190, and until shoulders 140 h abut against aproximal-most end of side walls 190 a of drive channel 190.

As seen in FIGS. 73-75, once catch 196 a of trip lever 196 is moved outof engagement with window 156 e of pusher bar 156, pusher bar 156 isretracted in a proximal direction due to the biasing force exertedthereon by biasing member 158. Pusher bar 156 is retracted until pusher156 a thereof is positioned proximal of a backspan of a distal-mostsurgical clip of the stack of clips “C”.

As seen in FIG. 76, as pusher bar 156 is biased to the retractedposition, pusher bar 156 cams against latch member 162 of latch lock-out160 and thereby pivots distal portion 162 a of latch member 162 (e.g.,clockwise as shown) out of window 140 g formed in drive bar 140.

As seen in FIGS. 71, 72, 77 and 78, when stop 140 h of drive bar 140abuts against a proximal-most end of drive channel 190 and shoulders 140h abut against a proximal-most end of side walls 190 a of drive channel190, further distal advancement of drive bar 140 results in distaladvancement of drive channel 190. As drive channel 190 is advanceddistally, cut-out 190 e formed in side wall 190 a of drive channel 190cams against tooth 216 b of gear 216 of wedge plate rack mechanism 210and urges gear 216 to rotate, i.e., clockwise as shown. Rotation of gear216 results in proximal displacement of body portion 212 a of wedgeplate rack 212 of wedge plate rack mechanism 210 due to theinter-engagement of the set of teeth 216 a of gear 216 with rack 212 bof wedge plate rack 212.

As wedge plate rack 212 is moved proximally, biasing member 214 iscompressed between body portion 212 a of wedge plate rack 212 and stub153 e formed in and extending from channel 153 c of lower housing 152 b.Concomitantly therewith, body portion 212 a also moves tab 188 b ofwedge plate 188 in a proximal direction, thus causing distal end 188 aof wedge plate 188 to be withdrawn from between jaw members 106 c ofjaws 106, as seen in FIGS. 79 and 80. With reference to FIG. 79, whendistal end 188 a of wedge plate 188 is interposed between jaw members106 c, distal end 188 a of wedge plate 188 functions to maintain jawmembers 106 c spaced apart from one another so as to receive a surgicalclip “C1” (see FIG. 80) therebetween and prevent side-load pressure fromimpeding clip loading. With reference to FIG. 80, when distal end 188 aof wedge plate 188 is withdrawn from between jaw members 106 c, jawmembers 106 c are capable of being approximated toward one another toform a surgical clip “C1” disposed therebetween.

Turning now to FIGS. 81-94, as trigger 108 is further squeezed oractuated from the second stage of the initial stroke through a thirdstage of the initial stroke, as described above, trigger 108 causeswishbone link 122 to further move yoke 124 in a distal direction which,in turn, causes plunger 134 to further move distally and to further movedrive bar 140 distally, via shear pin 142. As seen in FIG. 81, biasingmember 136 is now fully compressed between yoke 124 and cap 144.

As seen in FIGS. 81 and 82, as trigger 108 is actuated through the thirdstage of the initial stroke, actuator plate 128 is distally advanced, inthe manner described above, thereby causing stem 130 b of actuationlever 130 to slidably cam around counter actuation surface 128 c. In sodoing, actuation lever 130 is rotated clockwise to come into contactwith a lever or electrical contact 132 d of processor 132 b and thuscause processor 132 b to change the image on display 132 a. For example,the image on display 132 a may indicate that a surgical clip “C” hasbeen fired or expelled from surgical clip applier 100.

As seen in FIGS. 81-84, 92 and 93, as trigger 108 is actuated,audible/tactile feedback member 126 functions to create an audible clickand/or a tactile vibration, thereby indicating to the user that trigger108 of surgical clip applier 100 has gone through a complete stroke. Inparticular, as trigger 108 is actuated, arm 126 a of tactile feedbackmember 126 rides over and/or along a rib 103 d formed in at least one ofright side half-section 103 a and left side half-section 103 b. As arm126 a reaches the end of rib 103 d, arm 126 a snaps over the end of rib103 d and comes into contact with surface 103 f of right sidehalf-section 103 a and left side half-section 103 b, thereby creatingand audible sound and a tactile vibration as arm 126 a comes intocontact with surface 103 f.

As seen in FIGS. 85-89, as trigger 108 is actuated through the thirdstage of the initial stroke, drive bar 140 is further advanced distally,thus causing drive channel 190 to be further advanced distally, in themanner described above. As drive channel 190 is further advanceddistally, as seen in FIGS. 85 and 86, tab 190 c of drive channel 190,extending into pocket 202 b of body portion 202 of slider joint 200,drags or urges body portion 202 of slider joint 200 in a distaldirection, thereby compressing biasing member 206 between body portion202 and stub 153 d of lower housing 152 b.

Also, as drive channel 190 is further advanced distally, as seen inFIGS. 88 and 89, a distal edge of drive channel 190 engages againstcamming surfaces 106 d of jaw members 106 c thus causing jaw members 106c to approximate toward one another and to form surgical clip “C1”interposed therebetween. Since U-shaped channel 230 is fixed to drivechannel 190 and moves therewith, U-shaped channel 230 functions to capdrive channel 190 so as to maintain jaw members 106 c within drivechannel 190 during the approximation of jaws members 106 c. As seen inFIG. 90, surgical clip “C1” may be formed or crimped onto a vessel “V”or any other biological tissue.

Also, as drive channel 190 is further advanced distally, as seen in FIG.91, rack 222 of pawl and rack assembly 220 is moved distally until pawltooth 224 a of pawl 224 is disposed within proximal recess 222 c of rack222.

As seen in FIG. 94 and as will be described in greater detail below, asdrive channel 190 is withdrawn in a proximal direction, rack 222 of pawland rack assembly 220 is moved in a proximal direction such that pawltooth 224 a of pawl 224 is moved out of proximal recess 222 c of rack222 and into engagement with teeth 222 a of rack 222. Also, pawl 224 iscanted, rotated or rocked about pawl pin 226 causing biasing member 228to deflect. Biasing member 228 functions to maintain tooth 224 a of pawl224 in engagement with teeth 222 a of rack 222, as well as to maintainpawl 224 in a rotated or canted position.

Turning now to FIGS. 95-99, return of trigger 108 to an un-squeezed orunactuated position, is shown. Return of trigger 108 to an un-squeezedor unactuated position is facilitated by the biasing action and forcesexerted on plunger 134 by biasing member 136.

As seen in FIG. 95, as trigger 108 is returned to the un-squeezedposition, wishbone link 122 moves yoke 124 in a proximal directionwhich, in turn, causes plunger 134 to move proximally and to move drivebar 140 proximally, via shear pin 142. As seen in FIG. 95, as drive bar140 is moved proximally, distal edge 140 h and stop 140 e of drive bar140 are backed away from tab 202 a of body portion 202 of slider joint200 thus causing tab 202 a to translate through elongate slot 140 d ofdrive bar 140 and increase the length and/or size of dwell “d”. As drivebar 140 is retracted proximally, biasing member 206 urges slider joint200 in proximal direction thereby acting on tab 190 c of drive channel190 to urge drive channel 190 in a proximal direction.

As seen in FIG. 97, as drive channel 190 is moved in a proximaldirection, jaw members 106 c of jaws 106 return to their un-approximatedcondition due to the natural spring bias thereof. As seen in FIG. 98, asdrive channel 190 is moved in a proximal direction, cut-out 190 e formedin side wall 190 a of drive channel 190 allows gear 216 to rotate, i.e.,counter-clockwise as shown. Rotation of gear 216 results in distaldisplacement of body portion 212 a of wedge plate rack 212 of wedgeplate rack mechanism 210 due to the force of biasing member 214 and theinter-engagement of the set of teeth 216 a of gear 216 with rack 212 bof wedge plate rack 212. As wedge plate rack 212 is moved distally, bodyportion 212 a also moves tab 188 b of wedge plate 188 in a distaldirection, thus causing distal end 188 a of wedge plate 188 to beinserted or reintroduced between jaw members 106 c of jaws 106, as seenin FIG. 99.

Turning now to FIGS. 100-102, the configuration of surgical clip applier100, following application of the last surgical clip “C”, is shown. Asseen in FIG. 100, when the last surgical clip “C” is advanced by pusherbar 156 into jaws 106, head portion 180 a of clip follower 180 is at adistal-most position due to the urging of biasing member 182. When headportion 180 a of clip follower 180 is at a distal-most position, ramp180 c of head portion 180 a cams against and urges distal portion 168 bof lock-out bar 168 of pusher-bar latch mechanism 166 in a directioncounter-clockwise, as shown, toward pusher bar 156 and into distalwindow 156 d of pusher bar 156. With distal portion 168 b of lock-outbar 168 positioned in distal window 156 d of pusher bar 156, when pusherbar 156 is retracted, pusher bar 156 is prevented from moving proximallyto the fully retracted position.

As seen in FIG. 101, since pusher bar 156 is prevented from movingproximally to the fully retracted position by distal portion 168 b oflock-out bar 168, as described above, distal portion 162 a of latchmember 162 is rotated counter-clockwise, as shown, into window 140 g ofdrive bar 140 by arm 164 a of biasing member 164. Latch member 162 isprevented from rotating fully by the abutment of proximal portion 162 bagainst an inner surface of shaft assembly 104 and/or outer tube 150.Distal portion 162 a of latch member 162 effectively blocks proximalmovement of drive bar 140 and thus prevents drive bar 140 from returningto a fully proximal position.

With drive bar 140 prevented from returning to the fully proximalposition, as seen in FIG. 102, rack 222 of pawl and rack assembly 220 isprevented from returning to a fully proximal position. As such, tooth224 a of pawl 224 fail to be received within distal recess 222 b of rack222 and thus fail to reset. Thus, tooth 224 a of pawl 224 remainsengaged with teeth 222 a of rack 222, and pawl 224 remains canted withrespect to rack 222. As such, rack 222 is prevented from moving in adistal direction because rack 222 is wedged by pawl 224 and can notreset itself.

With distal portion 168 b of lock-out bar 168 positioned in distalwindow 156 d of pusher bar 156, with distal portion 162 a of latchmember 162 rotated into window 140 g of drive bar 140, and with tooth224 a of pawl 224 remaining engaged with teeth 222 a of rack 222,trigger 108 of surgical clip applier 100 is prevented from movingdistally and/or proximally and the mechanism is locked.

As seen in FIGS. 103 and 104, if a user of surgical clip applier 100attempts to exert an excessive force onto trigger 108, the excessiveforce will be transmitted to shear pin 148 via plunger 134. Since drivebar 140 is prevented from moving distally, the excessive force onplunger 134 is transmitted to shear pin 148, causing shear pin 148 tofail or break at annular recesses 148 a thereof. Once shear pin 148 isbroken, plunger 134 is capable of moving in a distal direction, however,no force is capable of being transmitted to drive bar 140 via shear pin148.

As seen in FIGS. 6-8, surgical clip applier 100 includes a spring stop138 disposed within handle assembly 102 which keeps actuator plate 128from falling distally/proximally when surgical clip applier 100 is heldin a vertical orientation. In particular, spring stop 138 is fixedlysecured to actuator plate 128 and includes a resilient arm 138 a thatfrictionally or snap-fit engages a surface within housing 103. In thismanner, since actuator plate 128 is held in position by spring stop 138,actuator plate 128 does not freely move in a distal or proximaldirection as surgical clip applier 100 is maneuvered to a verticalorientation.

It should be understood that the foregoing description is onlyillustrative of the present disclosure. Various alternatives andmodifications can be devised by those skilled in the art withoutdeparting from the disclosure. Accordingly, the present disclosure isintended to embrace all such alternatives, modifications and variances.The embodiments described with reference to the attached drawing figuresare presented only to demonstrate certain examples of the disclosure.Other elements, steps, methods and techniques that are insubstantiallydifferent from those described above and/or in the appended claims arealso intended to be within the scope of the disclosure.

What is claimed is:
 1. An apparatus for application of surgical clips tobody tissue, the apparatus comprising: a) a handle assembly; b) a shaftassembly extending distally from the handle assembly and including anupper housing and a lower housing; c) a plurality of surgical clipsdisposed within the shaft assembly; d) jaws mounted adjacent a distalend portion of the shaft assembly, the jaws including a pair of jawmembers movable between a spaced-apart position and an approximatedposition; e) a drive bar at least partially disposed within the handleassembly and the shaft assembly, the drive bar being longitudinallymovable in response to actuation of a trigger of the handle assembly; f)a drive channel positioned adjacent the first and second jaw members tomove the jaw members from the spaced-apart position to the approximatedposition; and g) a wedge plate rack mechanism operatively interposedbetween a channel of the lower housing and the drive channel, the wedgeplate rack mechanism including: a wedge plate rack slidably disposedwithin the channel of the lower housing and the drive channel, the wedgeplate rack having a body portion, a rack extending distally from thebody portion, a tail extending proximally from the body portion, and astem extending from a bottom surface of the body portion; a biasingmember supported on the tail; and a gear pivotably connected to thelower housing and engaged with the wedge plate rack such that rotationof the gear in a first direction results in proximal displacement of thewedge plate rack and rotation of the gear in a second direction resultsin distal displacement of the wedge plate rack, wherein proximaldisplacement of the wedge plate rack moves the body portion in aproximal direction such that the jaw members are capable of beingapproximated toward one another to form a surgical clip therebetween anddistal displacement of the wedge plate rack moves the body portion in adistal direction such that the jaw members are in the spaced-apartposition, wherein the gear translates distal movement of the drivechannel into proximal movement of the wedge plate rack and proximalmovement of the drive channel into distal movement of the wedge platerack.
 2. The apparatus according to claim 1, wherein the gear includesat least one first tooth in operative engagement with the wedge platerack and an at least one second tooth in operative engagement with thedrive channel.
 3. The apparatus according to claim 2, wherein a sidewall of the drive channel defines a cut-out configured to cam againstthe at least one second tooth of the gear.
 4. The apparatus according toclaim 1, further including a wedge plate slidably supported in the shaftassembly, wherein the wedge plate includes a distal end configured anddimensioned for placement between the jaws when the jaws are in thespaced-apart position and when the drive channel is in a proximalposition.
 5. The apparatus according to claim 4, wherein a pocket isformed on an upper surface of the body portion that is in operativeengagement with a projection extending from the wedge plate, wherein thebody portion and the wedge plate are movable in the same direction. 6.The apparatus according to claim 5, wherein proximal movement of thewedge plate rack moves the projection of the wedge plate in a proximaldirection such that a distal portion of the wedge plate is withdrawnfrom between the jaws.
 7. The apparatus according to claim 1, wherein ashoulder of the drive bar abuts a proximal end of the drive channel suchthat distal advancement of the drive bar results in distal advancementof the drive channel.
 8. The apparatus according to claim 1, wherein thebiasing member is disposed between the body portion of the wedge platerack and a stub extending from the channel of the lower housing therebybiasing the wedge plate rack in the distal direction.
 9. The apparatusaccording to claim 8, wherein the tail of the wedge plate rack isslidably passed through the stub extending from the channel of the lowerhousing.
 10. The apparatus according to claim 1, wherein the biasingmember is a compression spring.
 11. An apparatus for application ofsurgical clips to body tissue, the apparatus comprising: a) a handleassembly; b) a shaft assembly extending distally from the handleassembly and including an upper housing and a lower housing; c) jawsmounted adjacent a distal end portion of the shaft assembly; the jawsincluding a pair of jaw members movable between a spaced-apart positionand an approximated position; d) a drive channel positioned adjacent thefirst and second jaw members to move the jaw members from thespaced-apart position to the approximated position; e) a wedge plateslidably supported in the shaft assembly, wherein the wedge plateincludes a distal end configured and dimensioned for placement betweenthe jaw members when the jaw members are in the spaced-apart positionand when the drive channel is in a proximal position; and f) a wedgeplate rack mechanism supported in the shaft assembly and including, awedge plate rack slidably disposed within the shaft assembly, the wedgeplate rack having a body portion, a rack extending distally from thebody portion, a tail extending proximally from the body portion, and astem extending from a bottom surface of the body portion; a biasingmember supported on the tail; and a gear pivotably connected to thelower housing and engaged with the wedge plate rack such that rotationof the gear in a first direction results in proximal displacement of thewedge plate rack and rotation of the gear in a second direction resultsin distal displacement of the wedge plate rack, wherein proximaldisplacement of the wedge plate rack moves the body portion in aproximal direction such that the distal end of the wedge plate iswithdrawn from between the jaw members and the jaw members are capableof being approximated toward one another to form a surgical cliptherebetween and distal displacement of the wedge plate rack moves thebody portion in a distal direction such that the distal end of the wedgeplate is reintroduced between the jaw members and the jaw members are inthe spaced-apart position, wherein the gear translates distal movementof the drive channel into proximal movement of the wedge plate rack andproximal movement of the drive channel into distal movement of the wedgeplate rack.
 12. The apparatus according to claim 11, wherein a pluralityof surgical clips is disposed within the shaft assembly, each cliphaving an outer width.
 13. The apparatus according to claim 11, thewedge plate rack mechanism is operatively interposed between a channelof the lower housing and the drive channel.
 14. The apparatus accordingto claim 11, wherein the gear includes at least one first tooth inoperative engagement with the rack and at least one second tooth inoperative engagement with the drive channel.
 15. The apparatus accordingto claim 14, wherein a side wall of the drive channel defines a cut-outconfigured to cam against the at least one second tooth of the gear. 16.The apparatus according to claim 11, wherein the biasing member isdisposed between the body portion of the wedge plate rack and a stubextending from the channel of the lower housing thereby biasing thewedge plate rack in the distal direction.
 17. The apparatus according toclaim 16, wherein a pocket is formed on an upper surface of the bodyportion that is in operative engagement with a projection extending fromthe wedge plate, wherein the body portion and the wedge plate aremovable in the same direction.
 18. The apparatus according to claim 17,wherein the biasing member is a compression spring.